Variables associated with speech and language therapy time for aphasia, apraxia of speech and dysarthria

ABSTRACT. The most common acquired communication disorders are aphasia, dysarthria and apraxia of speech. Determining the factors associated with speech therapy time of adults with these disorders can further the understanding of the speech and language rehabilitation process within the public service and linked to the health education process. Objective: To analyze the types of acquired neurological disorders of communication of patients treated during the first years of implementation of a medium complexity service, along with demographic data, and rehabilitation time; and to determine associations between rehabilitation time and age, education, type of communication disorder, neurological disease duration and having been seen by a trainee. Methods: A retrospective analysis of the records of patients with acquired neurological disorders of communication who started speech and language rehabilitation between 2010 and 2011 was performed. Results: A total of 86 cases with acquired disorders of communication were seen, of whom 66% had aphasia, 35% dysarthria and 26% apraxia of speech. Mean age was 59 years and stroke was the most frequent cause (71%). Fifty patients completed speech-language rehabilitation and had a mean therapy time of 12 months. Aphasia and apraxia of speech were associated with a longer rehabilitation time. Therapy time until discharge was not significantly associated with lesion duration, education, age or being seen by a trainee. Conclusion: The duration of speech therapy for acquired neurological disorders of communication is long and associated with the type of disorder.

摘要：最常见的获得性沟通障碍包括失语症（aphasia）、构音障碍（dysarthria）与言语失用症（apraxia of speech）。明确此类成人患者言语治疗时长的相关影响因素，有助于深化对公共服务体系内言语语言康复（speech and language rehabilitation）流程的认知，并可将康复流程与健康教育环节相衔接。
研究目的：分析某中等复杂度医疗服务机构运营初期接诊的获得性神经源性沟通障碍（acquired neurological disorders of communication）患者的类型，结合人口统计学资料与康复时长，探究康复时长与患者年龄、受教育程度、沟通障碍类型、神经系统疾病病程以及是否由受训医师（trainee）接诊之间的关联。
研究方法：对2010年至2011年间开始接受言语语言康复治疗的获得性神经源性沟通障碍患者的病历资料进行回顾性分析。
研究结果：共纳入86例获得性沟通障碍患者，其中66%罹患失语症，35%患有构音障碍，26%存在言语失用症。患者平均年龄为59岁，脑卒中为最常见的致病原因（占比71%）。50例患者完成了言语语言康复治疗，平均治疗时长为12个月。失语症与言语失用症患者的康复时长更长。出院前的治疗时长与病程、受教育程度、年龄以及是否由受训医师接诊均无显著关联。
研究结论：获得性神经源性沟通障碍患者的言语治疗周期较长，且与障碍类型密切相关。